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Clinical ResearchThe Case for Medical History in Physicians' Education

The Case for Medical History in Physicians’ Education

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Although medical historians have long promoted medical history as an important component of physicians’ knowledge, reasoning, and clinical practice,1 they have made no effort to determine what physicians or physicians-in-training themselves think of or know of medical history. We conducted the present survey to fill this informational void.

Materials and Methods

Study Population

Our study population consisted of 156 incoming first-year medical students (MS1), 127 graduating fourth-year students (MS4), and 29 alumni of the University of Maryland School of Medicine. Each participant completed and submitted anonymously a paper-based survey instrument.

Survey Instrument

The survey instrument consisted of 5 parts. Part 1 examined subjects’ attitudes regarding the value of medical history in physicians’ education. One question asked respondents if they believed knowledge of the history of medicine could make them better physicians; another series of questions asked them to endorse which of several possible items of clinical practice (eg, medical ethics, taking a patient history) they believed might be enhanced by knowledge of medical history. Part 2 concerned the era/year of key historical events; part 3 the country/region in which important events took place; part 4, authors of critical publications; and part 5, how particular works/discoverers influenced the evolution of medical knowledge. Each of these sections followed a “match column A with column B” format.

Statistical Analysis

Survey responses were entered into Excel 2016 (Microsoft Corporation, Redmond, Wash.) and checked for accuracy. In Part 1, we determined the frequency with which each item was endorsed by respondents. For parts 2 through 5, we determined the frequency of correct responses for each item for all respondents overall, as well as stratified by respondent type (eg, educational group, gender, specialty). Differences in the frequency of correct responses between the various strata were assessed using chi-squared and Fisher exact tests using SAS (version 9.3; SAS Institute, Cary, NC).

Results

The demographic characteristics of the respondents are shown in Table 1, their attitudes regarding the value of medical history in physician education in Table 2. Almost all of the respondents (99.4% of MS1, 95% of MS4, and 96.6% of alumni) answered “yes” to the question: “Do you believe knowledge of the history of medicine can make you a better doctor?”

To read this article in its entirety please visit our website.

-Philip A. Mackowiak, MD, Donna Parker, MD, Lindsay D. Croft, PhD, MS, Harvey B. Simon, MD, Section Editor

This article originally appeared in the April 2017 issue of The American Journal of Medicine.

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